This study aimed to teach theory of mind (ToM) skills to a sample of people with Autism Spectrum Disorder (ASD), through a virtual reality (VR) application. An intrasubject design incorporating pretest and posttest measures was used. Six participants, aged 13–30 years, took part in the study. Three participants were randomly assigned to the experimental condition, leaving the other three participants in the control condition. The VR app featured scenarios designed to explore the principle that seeing leads to knowing. Differential reinforcement and different aids were used during the teaching process. Results showed that all experimental participants exhibited improvements in their ToM tasks scores following the VR intervention. Based on the findings from this small sample, these results should be considered preliminary evidence that VR may support ToM skill development in people with ASD.
AmadorM. C.Molina-CobosF. J. (2012). Discriminación de las funciones que definen las emociones con personas con Síndrome de Down [Master's thesis, Universidad de Almería]. UAL Campus Repository. https://repositorio.ual.es/handle/10835/1069?show=full
2.
AndreouM.SkrimpaV. (2020). Theory of mind deficits and neurophysiological operations in autism spectrum disorders: A review. Brain Sciences, 10(6), 393. https://doi.org/10.3390/brainsci10060393
3.
BaghdadliA.BrisotJ.HenryV.MichelonC.SoussanaM.RattazC.PicotM. C. (2013). Social skills improvement in children with high-functioning autism: A pilot randomized controlled trial. European Child & Adolescent Psychiatry, 22(7), 433–442. https://doi.org/10.1007/s00787-013-0388-8
4.
Barnes-HolmesY.McHughL.Barnes-HolmesD. (2004). Perspective-taking and theory of mind: A relational frame account. The Behavior Analyst Today, 5(1), 15–25. https://doi.org/10.1037/h0100133
5.
Baron-CohenS.GoodhartF. (1994). The “seeing-leads-to-knowing” deficit in autism: The Pratt and Bryant probe. British Journal of Developmental Psychology, 12(3), 397–401. https://doi.org/10.1111/j.2044-835X.1994.tb00642.x
6.
BelliniS.AkullianJ. (2007). A meta-analysis of video modeling and video self-modeling interventions for children and adolescents with autism spectrum disorders. Exceptional Children, 73(3), 264–287. https://doi.org/10.1177/001440290707300301
7.
BohilC. J.AliceaB.BioccaF. A. (2011). Virtual reality in neuroscience research and therapy. Nature Reviews Neuroscience, 12(12), 752–762. https://doi.org/10.1038/nrn3122
8.
Bru LunaL. M.Martí-VilarM.González-SalaF. (2020). Revisión sistemática de intervenciones en prosocialidad y empatía en personas con TEA. Revista de Investigación Educativa, 38(2), 359–377. https://doi.org/10.6018/rie.39542
9.
CarneiroT.CarvalhoA.FrotaS.FilipeM. G. (2024). Serious games for developing social skills in children and adolescents with autism spectrum disorder: A systematic review. Healthcare, 12(5), 508. https://doi.org/10.3390/healthcare12050508
10.
ChengY.BololiaL. (2024). The effects of augmented reality on social skills in children with an autism diagnosis: A preliminary systematic review. Journal of Autism and Developmental Disorders, 54(5), 1317–1331. https://doi.org/10.1007/s10803-022-05878-4
11.
DechslingA.OrmS.KalandadzeT.SütterlinS.ØienR. A.ShicF.Nordahl-HansenA. (2022). Virtual and augmented reality in social skills interventions for individuals with autism spectrum disorder: A scoping review. Journal of Autism and Developmental Disorders, 52(12), 4692–4707. https://doi.org/10.1007/s10803-021-05338-5
12.
DelgadoU.MaresG. (2012). Generalización de la correspondencia decir-hacer a través de tareas de diferente complejidad. Revista mexicana de análisis de la conducta, 38(1), 24–38.
13.
DyrdaK.LucciK. D.Bieniek-PocielejR.BryńskaA. (2020). Therapeutic programs aimed at developing the theory of mind in patients with autism spectrum disorders – Available methods and their effectiveness. Psychiatria Polska, 54(3), 591–602. https://doi.org/10.12740/PP/108493
14.
FabriciusW. V.GonzalesC. R.PeschA.WeimerA. A.PuglieseJ.CarrollK.BolnickR. R.KupferA. S.EisenbergN.SpinradT. L. (2021). Perceptual access reasoning (PAR) in developing a representational theory of mind. Monographs of the Society for Research in Child Development, 86(3), 7–154. https://doi.org/10.1111/mono.12432
15.
FengH.LoY.TsaiS.CartledgeG. (2008). The effects of theory-of-mind and social skill training on the social competence of a sixth-grade student with autism. Journal of Positive Behavior Interventions, 10(4), 228–242. https://doi.org/10.1177/1098300708319906
16.
FlavellJ. H. (2004). Theory-of-mind development: Retrospect and prospect. Merrill-Palmer Quarterly, 50(3), 274–290. https://doi.org/10.1353/mpq.2004.0018
17.
FrolliA.SavareseG.Di CarmineF.BoscoA.SavianoE.RegaA.CarotenutoM.RicciM. C. (2022). Children on the autism spectrum and the use of virtual reality for supporting social skills. Children, 9(2), 181. https://doi.org/10.3390/children9020181
18.
GarnhamW. A.RuffmanT. (2001). Doesn’t see, doesn’t know: Is anticipatory looking really related to understanding or belief?Developmental Science, 4(1), 94–100. https://doi.org/10.1111/1467-7687.00153
19.
GuajardoN. R.WatsonA. C. (2002). Narrative discourse and theory of mind development. The Journal of Genetic Psychology: Research and Theory on Human Development, 163(3), 305–325. https://doi.org/10.1080/00221320209598686
20.
HadwinA. J.HowlinP.Baron-CohenS. (2015). Teaching children with autism to mind-read: The workbook. Wiley-Blackwell.
21.
HutchinsT. L.PrelockP. A.MorrisH.BennerJ.LaVigneT.HozaB. (2016). Explicit vs. applied theory of mind competence: A comparison of typically developing males, males with ASD, and males with ADHD. Research in Autism Spectrum Disorders, 21, 94–108. https://doi.org/10.1016/j.rasd.2015.10.004
22.
IpH. H. S.WongS. W. L.ChanD. F. Y.ByrneJ.LiC.YuanV. S. N.LauK. S. Y.WongJ. Y. W. (2018). Enhance emotional and social adaptation skills for children with autism spectrum disorder: A virtual reality enabled approach. Computers & Education, 117, 1–15. https://doi.org/10.1016/j.compedu.2017.09.010
23.
Johnson-GlenbergM. C. (2018). Immersive VR and education: Embodied design principles that include gesture and hand controls. Frontiers in Robotics and AI, 5, 81. https://doi.org/10.3389/frobt.2018.00081
24.
KandalaftM. R.DidehbaniN.KrawczykD. C.AllenT. T.ChapmanS. B. (2013). Virtual reality social cognition training for young adults with high-functioning autism. Journal of Autism and Developmental Disorders, 43(1), 34–44. https://doi.org/10.1007/s10803-012-1544-6
25.
KaufmanA. S.KaufmanN. L. (1990). Kaufman brief intelligence test manual. American Guidance Service.
26.
KovshoffH.GrindleC. F.HastingsR. P. (2006). Autism: A psychological perspective. In EssauC. A. (Ed.), Child and adolescent psychopathology: Theoretical and clinical implications (pp. 246–270). Routledge.
27.
LeBlancL. A.CoatesA. M.DaneshvarS.Charlop-ChristyM. H.MorrisC.LancasterB. M. (2003). Using video modeling and reinforcement to teach perspective-taking skills to children with autism. Journal of Applied Behavior Analysis, 36(2), 253–257. https://doi.org/10.1901/jaba.2003.36-253
28.
LiC.BelterM.LiuJ.LukoschH. (2023). Immersive virtual reality enabled interventions for autism spectrum disorder: A systematic review and meta-analysis. Electronics, 12(11), 2497. https://doi.org/10.3390/electronics12112497
29.
LópezA.ChainéS.GreenL.VelascoC.TorresL. (2021). Multiple-exemplar training of generalized self-control choice in children with ADHD. Revista Mexicana de Análisis de la Conducta, 47(1), 61–92. https://doi.org/10.5514/rmac.v47.i1.79748
LugoA. M.MathewsT. L.KingM. L.LamphereJ. C.DammeA. M. (2017). Operant discrimination training to establish praise as a reinforcer. Behavioral Interventions, 32(4), 341–356. https://doi.org/10.1002/bin.1485
32.
MaW.MaoJ.XieY.LiS.WangM. (2023). Examining the effects of theory of mind and social skills training on social competence in adolescents with autism. Behavioral Sciences, 13(10), 860. https://doi.org/10.3390/bs13100860
33.
MaoS. Y.ChiuH. M.YuY. T.ChenK. L. (2023). The associations of theory of mind with both general and theory-of-mind-related social interaction in children with autism spectrum disorder. Research in Autism Spectrum Disorders, 102, 102107. https://doi.org/10.1016/j.rasd.2023.102107
34.
MartinG.PearJ. J. (2019). Behavior modification: What it is and how to Do it (11th ed.). Routledge.
35.
MazurekM. O.EngelhardtC. R. (2013). Video game use in boys with autism spectrum disorder, ADHD, or typical development. Pediatrics, 132(2), 260–266. https://doi.org/10.1542/peds.2012-3956
36.
MazzaM.MarianoM.PerettiS.MaseduF.PinoM. C.ValentiM. (2017). The role of theory of mind on social information processing in children with autism spectrum disorders: A mediation analysis. Journal of Autism and Developmental Disorders, 47(5), 1369–1379. https://doi.org/10.1007/s10803-017-3069-5
37.
Montoya-RodríguezM. M.de Souza FrancoV. A.Molina CobosF. J.Tomás LlerenaC. (2024). Protocolo de enseñanza para las habilidades de toma de perspectiva (PEHToPe): Editorial Octaedro.
38.
MoriguchiY.BanM.OsanaiH.UchiyamaI. (2017). Relationship between implicit false belief understanding and role play: Longitudinal study. European Journal of Developmental Psychology, 15(2), 172–183. https://doi.org/10.1080/17405629.2017.1280022
39.
O'NeillS. J.McDowellC.LeslieJ. C. (2018). A comparison of prompt delays with trial-and-error instruction in conditional discrimination training. Behavior analysis in practice, 11(4), 370–380. https://doi.org/10.1007/s40617-018-0261-9
40.
O'RiordanM. A.PlaistedK. C.DriverJ.Baron-CohenS. (2001). Superior visual search in autism. Journal of Experimental Psychology: Human Perception and Performance, 27(3), 719–730. https://doi.org/10.1037//0096-1523.27.3.719
41.
ParsonsS.CobbS. (2011). State-of-the-art of virtual reality technologies for children on the autism spectrum. European Journal of Special Needs Education, 26(3), 355–366. https://doi.org/10.1080/08856257.2011.593831
42.
PaynterJ.PetersonC. C. (2013). Further evidence of benefits of thought-bubble training for theory of mind development in children with autism spectrum disorders. Research in Autism Spectrum Disorders, 7(2), 344–348. https://doi.org/10.1016/j.rasd.2012.10.001
43.
PenningtonR. C. (2010). Computer-assisted instruction for teaching academic skills to students on the autism spectrum disorders: A review of literature. Focus on Autism and Other Developmental Disabilities, 25(4), 239–248. https://doi.org/10.1177/1088357610378291
44.
PetersL. C.ThompsonR. H. (2018). How teaching perspective taking to individuals with autism spectrum disorders affects social skills: Findings from research and suggestions for practitioners. Behavior Analysis in Practice, 11(4), 467–478. https://doi.org/10.1007/s40617-018-0207-2
45.
PetersonC. C.WellmanH. M. (2009). From fancy to reason: Scaling deaf and hearing children’s understanding of theory of mind and pretence. British Journal of Developmental Psychology, 27(2), 297–310. https://doi.org/10.1348/026151008X299728
46.
PetersonC. C.WellmanH. M.LiuD. (2005). Steps in theory-of-mind development for children with deafness or autism. Child Development, 76(2), 502–517. https://doi.org/10.1111/j.1467-8624.2005.00859.x
47.
PrattC.BryantP. (1990). Young children understand that looking leads to knowing (so long as they are looking into a single barrel). Child Development, 61(4), 973–982. https://doi.org/10.2307/1130869
48.
RizzoA.KoenigS. T. (2017). Is clinical virtual reality ready for primetime?Neuropsychology, 31(8), 877–899. https://doi.org/10.1037/neu0000405
49.
SmithT.MruzekD. W.WheatL. A.HughesC. (2006). Error correction in discrimination training for children with autism. Behavioral Interventions, 21(3), 245–263. https://doi.org/10.1002/bin.223
50.
StokesT. F.BaerD. M. (1977). An implicit technology of generalization. Journal of Applied Behavior Analysis, 10(2), 349–367. https://doi.org/10.1901/jaba.1977.10-349
51.
Taylor-SantaC.KisamoreA. N.ReeveS. A.SidenerT. M. (2015, October). Perspective taking: A functional account and review of the literature. In ReeveS. A. (Ed.), Teaching children with autism complex social skills. Symposium conducted at the meeting of the Berkshire Association for Behavior Analysis and Therapy.
Unity Technologies. (2024). Unity real-time development platform. https://unity.com/
55.
Van PeltB.NijmanS.van HarenN.VelingW.PijnenborgG.van BalkomI.LandlustA.Greaves-LordK. (2022). Dynamic interactive social cognition training in virtual reality (DiSCoVR) for adults with autism spectrum disorder: A feasibility study. Research in Autism Spectrum Disorders, 96, 102003. https://doi.org/10.1016/j.rasd.2022.102003
56.
VassE.FeketeZ.LencseL.EcseriM.KisB.Szekrényes-VargaÁ.PálfyP.SimonL. (2019). Treatment of theory of mind deficits in schizophrenia by using virtual reality, the VR-ToMIS training (virtual reality based theory of mind intervention in Schizophrenia). Psychiatria Hungarica: A Magyar Pszichiatriai Tarsasag Tudomanyos Folyoirata, 34(3), 287–299.
57.
VassE.SimonV.CsuklyG.FeketeZ.KisB.SimonL. (2022). Virtual reality-based theory of mind intervention in schizophrenia: Preliminary efficacy results. Comprehensive Psychiatry, 119, 152350. https://doi.org/10.1016/j.comppsych.2022.152350
58.
WellmanH. M. (2011). Developing a theory of mind. In GoswamiU. (Ed.), The Wiley-Blackwell handbook of childhood cognitive development (2nd ed., pp. 258–284). Wiley Blackwell.
59.
WellmanH. M.FangF.LiuD.ZhuL.LiuG. (2006). Scaling of theory-of-mind understandings in Chinese children. Psychological Science, 17(12), 1075–1081. https://doi.org/10.1111/j.1467-9280.2006.01830.x
